A 26-year-old woman comes to the physician for a follow-up appointment. She recently had a miscarriage and wants to discuss options for future care.

Which of the following is the most likely to be seen in this patient?

A) Anti-cyclic citrullinated peptide antibodies
B) Anti-histone antibodies
C) Increased partial thromboplastin time
D) Increased platelet count
E) Syphilis

A 7-year-old boy is brought to the physician by his mother. A blood smear is shown.

Which of the following is most likely to be seen in this patient?

A) Decreased NADH production
B) Decreased disulfide group production
C) Decreased thiol group production
D) Dominant inheritance pattern
E) Howell-Jolly bodies

A 25-year-old man comes to the physician for a follow-up appointment. Hydroxyurea therapy is prescribed. Which of the following is most likely to be seen in this patient as a result of this pharmacotherapy?

A) Decreased sickle hemoglobin expression
B) Decreased sickling due to decreased acidification
C) De-repression of fetal globin chain genes
D) Increased HbA2 production
E) Increased thymidine fraction

A 64-year-old man is being managed in hospital for a hematologic condition. During the course of his chemotherapy, he develops bleeding from IV lines. A blood smear is shown.

Which of the following is most likely to be seen in this patient?

A) Decreased fibrinogen
B) Decreased fibrin degradation products
C) Decreased plasmin activity
D) Decreased prothrombin time
E) Increased plasminogen

A 12-year-old girl is brought to the physician for a follow-up appointment. She has had no recent illnesses. Vitals are normal. Her had a history of “anemia” that was treated with splenectomy in early adulthood. A blood smear is shown.

If left untreated, this patient is at greatest risk for developing which of the following?

A) Cholelithiasis
B) Coombs test positivity
C) Disseminated intravascular coagulation
D) Microangiopathic hemolytic anemia
E) Normal ferritin with decreased serum iron

A 63-year-old man comes to the physician for a follow-up appointment. He has had intermittent headache for the past two months and occasional blurry vision. For the past week he has had increased diffuse bodily itching following his nightly shower. Laboratory studies show:

Hemoglobin                                    18.0 g/dL
Leukocytes                                      14,000/μL
Platelets                                            300,000/μL
Serum calcium                               9.0 mg/dL

Which of the following is most likely to be seen in this patient?

A) Decreased erythropoietin
B) Kappa light chain IgM spike
C) Lambda light chain IgG spike
D) Nephrotic syndrome
E) Serum basophils of 1.0%

A 32-year-old woman comes to the physician for a routine health maintenance examination. MCV is 72 fL. Serum iron and ferritin are within reference range. Which of the following is most likely to be seen in this patient?

A) Decreased HbF
B) Decreased porphobilinogen deaminase
C) Helmet cells
D) Increased HbA2
E) Pappenheimer bodies

A 15-year-old boy is brought to the physician by his parents for a follow-up examination. His laboratory studies are shown:

Bleeding time                                                        8 minutes
Prothrombin time                                              14 seconds
Partial thromboplastin time                        48 seconds
Platelet count                                                       220,000/μL

Which of the following is the most likely explanation for this patient’s findings?

A) Antibodies against glycoproteins IIb/IIIa
B) Defective glycoprotein IIb/IIIa
C) Deficiency of clotting factor
D) Reduced bridging of glycoprotein Ib to endothelium
E) Reduced cofactor for gamma-glutamyl carboxylase

A 30-year-old man comes is evaluated in hospital. His father has a history of cirrhosis. His arterial bloods are shown:

pH                                             7.39
HCO3^–                                    24 mEq/L
O2 content                          Reduced
pO2                                         90 mmHg
pCO2                                      38 mmHg

Which of the following is the most likely explanation for this patient’s findings?

A) Alpha-1 antitrypsin deficiency
B) Anemia
C) Polycythemia vera
D) Salicylate poisoning
E) Ventilation/perfusion mismatch

A 34-year-old woman is evaluated in hospital. She has no past medical history. Vitals are stable.

Which of the following is most likely to be seen in this patient?

A) Creatinine of 1.0 mg/dL
B) Fibrinogen of 80 mg/dL
C) Hemoglobin of 18.5 g/dL
D) Holosystolic murmur at lower left sternal border
E) Platelets of 560,000/μL